Andrea Buron1, Marta Román2, Josep M Augé3, Francesc Macià2, Jaume Grau4, Maria Sala2, Javier Louro2, Montserrat Martinez-Alonso5, Cristina Alvarez-Urturi6, Montserrat Andreu6, Xavier Bessa6, Diana Zaffalon6, Antoni Castells7, Maria Pellisé7, Marta Aldea4, Liseth Rivero7, Cristina Hernández8, Isabel Torá-Rocamora4, Xavier Castells2. 1. Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; REDISSEC (Health Services Research on Chronic Patients Network), Madrid, Spain. Electronic address: aburon@parcdesalutmar.cat. 2. Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; REDISSEC (Health Services Research on Chronic Patients Network), Madrid, Spain. 3. Biochemistry and Molecular Genetics Department, Hospital Clínic, Barcelona, Spain; IDIBAPS (August Pi i Sunyer Biomedical Research Institute), Barcelona, Spain. 4. Unit of Evaluation, Support and Prevention, Hospital Clinic, Barcelona, Spain. 5. Biomedical Research Institut of Lleida (IRBLLEIDA), Lleida, Catalonia, Spain. 6. Gastroenterology Department, Hospital del Mar, Barcelona, Spain. 7. IDIBAPS (August Pi i Sunyer Biomedical Research Institute), Barcelona, Spain; Gastroenterology Department, Hospital Clínic, Barcelona, Spain; CIBERehd (CIBER for Digestive and Liver Diseases), Madrid, Spain. 8. Epidemiology and Evaluation Department, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
Abstract
INTRODUCTION: Increased values in the fecal immunochemical test (FIT) are correlated with increasingly severe colorectal neoplasia, but little attention has been given to FIT values below the cut-off point (negative FIT, nFIT). We analysed the relationship between the concentrations of two consecutive nFIT and the risk of following screen-detected advanced neoplasia and interval cancer (IC) in a population-based colorectal cancer screening program. METHODS: FIT results were categorised into non-detectable nFIT (0-3.8 μg haemoglobin/g feces), low nFIT (3.9-9.9) and high nFIT (10.0-19.9). Multivariable adjusted logistic regression was used to estimate the odds ratios (OR) of advanced neoplasia and IC with the nFIT results in the first two screens. RESULTS: More than 90% of the 42,524 persons had non-detectable nFIT in the first and second screen; 4.5% and 5.8% had a low nFIT, respectively, and 2.2% and 2.9% had a high nFIT. The probability of testing positive and being diagnosed of advanced neoplasia or IC rose with increasing values of nFIT. Compared with those with two non-detectable nFIT results, the highest OR were found among those who had two high nFIT results (OR 21.75; 95% confidence interval: 12.44, 38.04) and those with one low nFIT and one high nFIT (ORs around 20). CONCLUSIONS: Participants with nFIT results above the detection limit of the test had an increased risk of advanced neoplasia and IC in subsequent participations. This information could be used in the design of personalised screening strategies.
INTRODUCTION: Increased values in the fecal immunochemical test (FIT) are correlated with increasingly severe colorectal neoplasia, but little attention has been given to FIT values below the cut-off point (negative FIT, nFIT). We analysed the relationship between the concentrations of two consecutive nFIT and the risk of following screen-detected advanced neoplasia and interval cancer (IC) in a population-based colorectal cancer screening program. METHODS: FIT results were categorised into non-detectable nFIT (0-3.8 μg haemoglobin/g feces), low nFIT (3.9-9.9) and high nFIT (10.0-19.9). Multivariable adjusted logistic regression was used to estimate the odds ratios (OR) of advanced neoplasia and IC with the nFIT results in the first two screens. RESULTS: More than 90% of the 42,524 persons had non-detectable nFIT in the first and second screen; 4.5% and 5.8% had a low nFIT, respectively, and 2.2% and 2.9% had a high nFIT. The probability of testing positive and being diagnosed of advanced neoplasia or IC rose with increasing values of nFIT. Compared with those with two non-detectable nFIT results, the highest OR were found among those who had two high nFIT results (OR 21.75; 95% confidence interval: 12.44, 38.04) and those with one low nFIT and one high nFIT (ORs around 20). CONCLUSIONS:Participants with nFIT results above the detection limit of the test had an increased risk of advanced neoplasia and IC in subsequent participations. This information could be used in the design of personalised screening strategies.
Authors: Iris Lansdorp-Vogelaar; Reinier Meester; Lucie de Jonge; Andrea Buron; Ulrike Haug; Carlo Senore Journal: Int J Cancer Date: 2021-09-06 Impact factor: 7.316
Authors: Arthur I Kooyker; Esther Toes-Zoutendijk; Annemieke W J Opstal-van Winden; Manon C W Spaander; Maaike Buskermolen; Hanneke J van Vuuren; Ernst J Kuipers; Folkert J van Kemenade; Chris Ramakers; Maarten G J Thomeer; Evelien Dekker; Iris D Nagtegaal; Harry J de Koning; Monique E van Leerdam; Iris Lansdorp-Vogelaar Journal: Int J Cancer Date: 2020-01-09 Impact factor: 7.396
Authors: Craig Mowat; Jayne Digby; Shirley Cleary; Lynne Gray; Pooja Datt; David R Goudie; Robert Jc Steele; Judith A Strachan; Adam Humphries; Callum G Fraser Journal: Ann Clin Biochem Date: 2022-03-02 Impact factor: 2.587
Authors: Noel Pin-Vieito; Laura García Nimo; Luis Bujanda; Begona Román Alonso; María Ángeles Gutierrez-Stampa; Vanessa Aguilar-Gama; Isabel Portillo; Joaquín Cubiella Journal: United European Gastroenterol J Date: 2021-03-01 Impact factor: 4.623